We propose to conduct a study to explore specific oral health outcomes in relation to new generation immunosuppressants in a population of pediatric renal transplant recipients (RTRs) and liver transplant recipients (LTRs) at UCSF. Oral health outcomes of interest include mucosal diseases (e.g., candidiasis, hairy leukoplakia, ulcers, warts, lip carcinoma, non-Hodgkin's lymphoma, and Kaposi's sarcoma (KS), gingival enlargement (GE), and dental needs. The principal investigator of the proposed study is a recipient of a K23 award that bears as its central theme the study of oral health outcomes among adult RTRs. Dr. Shiboski also received a small amount of pilot funds to study utilization of dental care among medically compromised children. As part of this pilot project she has been recruiting, and administering oral health questionnaires to pediatric RTRs and LTRs at UCSF. [unreadable] [unreadable] Taking advantage of this developing research infrastructure, the goal of the present application is to request funds to conduct a prospective study among pediatric RTRs and LTRs, exploring specific oral health outcomes by following these children at 6-months intervals over a 2-year period. [unreadable] [unreadable] The Specific Aims of the proposed study among pediatric RTRs and LTRs are: [unreadable] [unreadable] a. To estimate the prevalence and incidence of oral mucosal diseases and GE in relation to new immunosuppressive drug regimens, type of transplant, and time since transplant surgery; [unreadable] b. To estimate the prevalence of unmet dental need in relation to socio-demographic variables and time since transplant surgery; [unreadable] c. To collect preliminary data on any potential association between unmet dental needs (e.g., advanced caries, chronic gingival inflammation associated with GE) and history of acute graft rejection episode(s). [unreadable] [unreadable]